The present invention relates generally to surgical instruments and procedures, and more particularly to a method and apparatus for suturing tissue.
One feature associated with the evolving field of medical technology is the continual effort to develop methods for repairing human tissue which require less disruption of the tissues and organs which surround an area requiring repair. In this regard, various forms of orthopedic surgery that once required that a large portion of a joint to be exposed during surgery can now be performed by making several small incisions. During such surgery, a fiber optic probe and various instruments are inserted into the incision to allow a surgeon to inspect and/or remove the damaged tissue without unduly damaging the surrounding non-injured tissue. This type of surgery is generally known as arthroscopic surgery.
While arthroscopic surgery when available is often the preferred form of surgery because of its less intrusive nature, there are certain difficulties which the surgeon may encounter during such surgery. One problem is that suturing tissue during arthroscopic surgery is somewhat difficult because a surgeon must manipulate the suturing instruments through a relatively small incision. One device which has been developed for facilitating suturing during arthroscopic surgery is the Shutt suture punch manufactured by Concept Incorporated. This particular instrument has a cannulated or hollow needle secured to a jaw positioned near the end of a long tube. The jaw can be manipulated by a hand grip to press the needle through the tissue to be sutured. Suture material is then fed through the tube from a spool attached to the hand grip into the hollow needle and therefore through the tissue. Enough suture material is advanced through the needle so that when the needle is withdrawn from the tissue and the instrument is removed from the incision, a portion of the suture material remains within the tissue. The suture material is then tied in a manner well-known in the art so as to secure the suture material to the tissue.
While this instrument is generally effective in suturing tissue, there are several disadvantages with respect to the use of this instrument. For example, the instrument requires manually advancing the suture material through the needle by manipulating the spool which is often somewhat difficult to do during surgery. In addition, the surgeon must verify that enough suture material has been advanced through the needle so that when the instrument is withdrawn from the incision, the suture material is not inadvertently pulled through the tissue. Furthermore, because the suture material must be fed up and through a hollow needle, tissue or other debris present in the surgical site may block the opening in the needle making it difficult to pass the suture material through the needle. In addition, because rotating the spool against the braided suture material tended to cause the braided suture material to expand such that it was unable to pass through the tube, only monofilament suture material can generally be used. This is disadvantageous because braided suture material is generally stronger than monofilament suture material. Finally, this particular instrument cannot generally be used to simultaneously pass several segments of suture material through the tissue which is required for certain types of sutures such as a mattress suture.